Influence of detection of pretreatment cytogenetic abnormalities on first complete remission and survival in adult acute lymphoblastic leukemia

Objective: Treatment of acute lymphoblastic leukemia (ALL) in adults focuses on the initial assessment of the prognostic relevant cytogenetic features as well as a response-guided therapy based on molecular data. We examined the importance of molecular-cytogenetic abnormalities for complete remission (CR) rates and the overall survival (OS) in adult ALLs.Materials and Methods: Conventional cytogenetics and fluorescence in situ hybridization were performed on bone marrow cells from 33 newly-diagnosed ALL adults. Two karyotype categories [standard- risk group- normal karyotype, hyperdiplody and other structural aberrations, and high-risk group-t(11q23)/MLL, t(9;22)/bcr-abl, t(1;19), t(8;14), C-MYC and complex karyotype] and the biologically and clinically relevant ALL ploidy subgroups were prospectively defined.Results: Chromosomal abnormalities were found in 52% of the cases with a high rate of poor-risk translocations - t(9;22), t(8q24), t(11q23), t(1;19). The total CR rate was 67% and the median time for achievement 2.33 months. Male sex, an age below 35 years and the absence of high risk translocations might have contributed to the high CR rates. Female patients, hyperdiplody, low white blood cells (WBC), and random cytogenetic aberrations had the longest OS. OS, 3- and 5-years survival periods were significantly shorter for poor-risk than standard risk group (p=.015, p=.001 and p=.005, respectively).Conclusion: This study emphasizes the lack of influence of cytogenetic aberrations on the CR and the time to achieve CR. However, our observations show that these aberrations are an independent prognostic factor in adult ALL - they allow predicting therapy resistance and the OS time after intensetreatment

The Effective Concertmaster: A Look at the 21st Century Role

The role and responsibilities of the orchestral concertmaster have evolved alongside the orchestra over the last several centuries, shifting away from composing music for the ensemble and organizing events, and towards being aware of union standards, etiquette, and musician morale, as well as the important task of writing bowings. What makes an effective concertmaster? In attempting to answer this question, this paper will be examining both the musical and extra-musical duties of the modern day concertmaster, primarily focusing on leadership qualities such as cueing and leading with the bow. The paper will draw on biographical sources of current concertmasters of major orchestras and examining their personality and leadership style, with special focus on second-hand accounts of how their leadership style is perceived. The “effectiveness” of a concertmaster will be determined by their success in the field, reception from players in their section or orchestra, and primary source analyses of video and audio materials of their work. In answering the question at hand, the paper aims to provide useful information to aspiring leaders and concertmasters by analyzing the qualities of good leadership

Supervision – A Prerequisite For Trust In Autonomous Nursing Practice

The nurse is viewed as a central figure in all modern healthcare systems. In accordance with the needs and wants of the population, opportunities are provided for nurses to manage their autonomous practice within the framework of acquired competencies. Nurses in the modern world share a new philosophy of care and offer it to patients through different organizational models, seeking to improve efficiency to make the cost equally affordable. The need to introduce clinical supervision in nursing practice, as well as the factors influencing the development of nursing, are discussed. A Model of Supervision in Bulgaria and a Continuum of a Nursing Supervisor in Bulgaria have been developed and presented

Practical approaches to limit turnover nurses

Turnover of health care professionals in our country is particularly topical issue in modern conditions. There is a need for a new attitude to management turnover at medical professionals, analyze and refine their professional development. The aim of the study is to investigate the opinion of nursing leaders and health care sectors of intensive work and offer practical approaches to limit turnover. The most of managers are convinced that adequate material compensation is the basis on which must be built motivational incentive for staff retention (65.80%). The introduction of a modern system of appraisal is among the strategic objectives of 39.00%, while investments in training programs and qualification support and apply only in 36.60% of managers in health care. Self-developed and proposed - Model corrective policy management turnover and Model professional managerial governance and Approach to identifying problems and limiting turnover

Factors Affecting Staff Turnover in Dental Technician Laboratories

INTRODUCTION: Human resources management is a system of activities that effectively utilizes personnel to achieve the goals of an organization while satisfying the needs of its employees. A company’s success lies in its ability to attract and retain the right employees who are satisfied with their roles and work environment, leading to long-term productivity. As the head of a dental laboratory, a dental technician performs all levels of management simultaneously.AIM: To investigate the opinions of managers of dental technician laboratories, dental technicians, and dentists regarding the factors affecting staff turnover in dental technician laboratories.MATERIALS AND METHODS: Literary sources were reviewed, and an anonymous survey was conducted to achieve the research goal. The study included 250 participants from the cities of Varna, Bourgas, and Dobrich (126 dental technicians - hired workers, 58 managers of dental laboratories, and 66 dentists). Graphical and comparative analyses were used to present and interpret the data.RESULTS: The main factor affecting staff turnover, according to managers (82.76%) and dental technicians (69.84%), is unsatisfactory payment. Dentists, however, indicated workplace conflicts (92.42%) as the primary factor.CONCLUSION: For a dental technician laboratory to be successful, it is important for employers to attract and retain employees. The data from this study can help managers reduce the turnover of dental technicians, improve their practices, and strengthen their positions in the health services market

Study Of The Quality Of Life Of Relatives Of Stroke Survivors

INTRODUCTION: The consequences of stroke are severe both for the patient and for his family. Very often communication is disturbed, and depression is a constant companion for both the patient and his family.         AIM: This study aims to identify changes in the quality of life of relatives of patients suffering from stroke.MATERIALS AND METHODS: A total of 70 relatives were interviewed. Changes in professional environment, socialization and leisure time, as well as obligations for daily patient support, have been studied.RESULTS AND DISCUSSION: The need to care for a patient suffering from a stroke directly affects the quality of life of their relatives. Depending on the consequences, a number of changes to the family's day-to-day work are required - change of work, need for additional income, daily care for the patient, lack of leisure time, etc.        CONCLUSION: The preparation and training of patients suffering from stroke depending on their condition or their relatives during the hospital stay, synchronized with the healing process and the rehabilitation measures, would help to restore self-care and independence in day-to-day activities, and improve the quality of life of stroke survivors lowering the cost for the patient and his family, and preventing recurrences

MIXED INFLUENZA-ADENOVIRAL INFECTIONS AMONG WORKING STAFF DURING THE PERIOD 1975—1979

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Аggression In Emergency Care

Increasingly, the issue of aggression and violence is also considered in medical practice. Aggression is a global problem in our time with high public importance. The analysis of this specific topic is related to numerous studies, looking for effective barriers to overcome it. Aggression has been analyzed by many sciences, such as sociology, pedagogy, psychology, etc. The emergency wards and emergency medical centers are units with high labor intensity. The medical specialists providing emergency aid are often subject to aggressive behavior. Furthermore, the labor activity of the medical specialists from emergency departments and emergency medical centers are subject to verbal and physical threats. The aggressor is usually a patient or his relatives. Undoubtedly, this increases the stress at the workplace and it affects the health of medical professionals and the quality of the provided health care. Workplace aggression also affects job satisfaction, which is closely related to the motivation of the particular individual. On the other hand, the job satisfaction of medical specialists is affected by stress, workload, self-respect, creativity, inspiring work environment and sense of achievement, social status and others that are directly related to the commented workplace aggression